<html>
<head>
	<title>Customers Add</title>
</head>

<body>
	<h1>Add a new customer</h1>
	
	
	<form action="save" method = "post">
		First Name: <input type="text" name="first_name">  <br />
		Last Name: <input type="text" name="last_name"> <br />
		Middle Initial: <input type="text" name="middle_initial"> <br />

		<label>Date of Birth</label>
			<?=$formdate->selectMonth()?>  
			<?=$formdate->selectDay()?>    
			<?=$formdate->selectYear()?>    
		<br />	
		<!-- Populate the Customer Gender Lookup Field -->
		Gender: <select name="customer_gender_id">
		<?php
			foreach ($genders as $gender) {
				echo "<option value='" . $gender->customer_gender_id . "'>" . $gender->customer_gender . "</option>";
			}
		?>
		</select> <br />
		
		<!-- Populate the Customer Race Lookup Field -->
		Race: <select name="race_id">
		<?php
			foreach ($races as $race) {
				echo "<option value='" . $race->race_id . "'>" . $race->race_description . "</option>";
			}
		?>
		</select> <br />
		
		Home Address: <input type="text" name="home_address"> <br />

		<!-- Populate the City Lookup Field -->
		City: <select name="home_city_id">
		<?php
			foreach ($cities as $city) {
				echo "<option value='" . $city->home_city_id . "'>" . $city->city . "</option>";
			}
		?>
		</select> <br />
		
		<!-- Populate the State Lookup Field -->
		State: <select name="state_id">
		<?php
			foreach ($states as $state) {
				echo "<option value='" . $state->state_id . "'>" . $state->state_name . "</option>";
			}
		?>
		</select> <br />
		
		Home Phone: <input type="text" name="home_phone"> <br />
		Work Name: <input type="text" name="work_name"> <br />
		Work Phone: <input type="text" name="work_phone"> <br />
		PhotoId Number: <input type="text" name="photo_id_number"> <br />
		PhotoId Type: <input type="text" name="photo_id_type"> <br />
		PhotoId State: <input type="text" name="photo_id_state"> <br />
		Height: <input type="text" name="height"> <br />
		Weight: <input type="text" name="weight"> <br />
		
		<!-- Populate the Eye Color Lookup Field -->
		Eye Color: <select name="eye_color_id">
		<?php
			foreach ($eye_colors as $eye_color) {
				echo "<option value='" . $eye_color->eye_color_id . "'>" . $eye_color->eye_color . "</option>";
			}
		?>
		</select> <br />
		
		<!-- Populate the Hair Color Lookup Field -->
		Hair Color: <select name="hair_color_id">
		<?php
			foreach ($hair_colors as $hair_color) {
				echo "<option value='" . $hair_color->hair_color_id . "'>" . $hair_color->hair_color . "</option>";
			}
		?>
		</select> <br />
		
		Notes: <textarea wrap="OFF" name="customer_note"></textarea> <br />
		
		<input type="submit" value="submit" name="submit"><br />
	</form>
	
	
</body>

</html>


